[Computerised dosimetry in interstitial management with 192Ir sources (author's transl)].
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Biomedical subjects
Publications and source records attributed to P Feroldi.
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AIMS AND BACKGROUND: The purpose of this study was to investigate the palliative effectiveness of an interstitial fractionated high-dose-rate (HDR) brachytherapy regimen in patients with poor-prognosis, high-grade glioma. METHODS: An after-remote-loading microSelectron HDR lr-192 370 GBq unit was used. A unique coaxial after-loading catheter was stereotactically inserted through the center of the target volume. The treatment schedule was: 5 fractions, 5 Gy per fraction, or alternatively 7 fractions, 3.85 Gy per fraction, at the dose specification surface, 2 fractions per day. Twenty-four patients have been treated: in 17 of them (T1 G3-4) the catheter was implanted during stereotactic biopsy procedure; in the other 7 cases (T2 G3-4), subjected to partial resection and reduced to yT1, the catheter was implanted following surgery with a mean delay of 15 days. RESULTS: The treatment was feasible and well tolerated. The complete course takes no more than 7 days. The acute complication rate (2/24) seems to be acceptable. The median survival was 8 months. No less than 45% of the patients had a WHO grade 2 score or better at any time of follow-up. At 4 months of follow-up, functional status, assessed using a verbally administered Barthel index, had improved from the pretreatment level in 29.1% of the 18 surviving patients and remained stable in another 22.2%. A minimal response or stable disease, according to CT scan, was obtained in about half of the assessable survivors at any time of follow-up. CONCLUSIONS: The short course of brachytherapy provides a good palliation in terms of functional improvement in a high proportion of patients, with low and acceptable toxicity.
Clinical, scientific and technological development has greatly widened the scope and range of oncological radiotherapy. As for database management, favorable conditions come from new available hardware and software facilities and from well-consolidated and universally accepted classifications. The authors' aim was to create and to verify an original database management system for oncological radiotherapy, proved with internationally accepted classifications and directly interfaced to a new package for clinical and epidemiological statistics. An ordinary personal computer was used and a 802-subject statistics was analyzed relative to 1987-1988 series from the Istituto del Radio "O. Alberti", General Hospital and University - Radiotherapy Department, Brescia, Italy. The system seems to be suitable for routine use as well as for research, with good potentials for multicentric use.